Minoxidil and Initial Shedding: Prevention Tips

What’s the key point of this article?

1. What is initial shedding loss? Medications commonly used for AGA treatment, including minoxidil, may cause temporary increased hair shedding after starting use. This occurs as new hair pushes out old hair and is usually transient. 2. The duration and amount of hair shedding during the initial shedding phase It typically begins within two months of starting treatment and is expected to last for about one month. It may occur again around six months later, but if the period is prolonged or recurrent, it is necessary to check for other underlying conditions or causes of hair loss. 3. How to deal with initial shedding Since it is difficult to suppress hair shedding, we recommend reviewing your lifestyle habits and shampoo, and using wigs or hats as needed to make daily life more comfortable.

When using minoxidil or dutasteride, initial shedding may occur.

Many individuals considering AGA treatment express concern upon hearing about “initial shedding”.

AGA treatments using minoxidil or dutasteride aim to suppress the harmful male hormone “DHT (dihydrotestosterone)” and restore a normal hair growth cycle.

So why does hair loss occur with AGA medications designed to restore a normal hair growth cycle?

This time, we’ll explain the causal relationship between AGA medications and initial hair shedding, along with how to handle it if it occurs.

For information on AGA symptoms, causes, and prevention measures, please see the following article.

What is Initial Shedding?

Initial shedding is a temporary increase in hair loss observed after starting minoxidil, a medication frequently used in AGA (androgenetic alopecia) treatment. This situation can be a source of anxiety for many people.

The reason is that minoxidil regulates the hair growth cycle, promoting hair follicles in the resting phase to enter the growth phase. Specifically, new hair pushing out old hair from the root manifests as temporary shedding.

Since initial shedding is a major cause of regret in AGA treatment, having the correct knowledge is crucial.

Increased hair loss → Why it doesn’t mean AGA treatment has failed

A common misconception among men, especially those considering or just starting treatment, is that increased hair shedding means the treatment is failing. However, this increased shedding is a necessary phenomenon to promote new hair growth and ultimately leads to increased hair volume in the long term.

In other words, old hair needs to make way for new hair growth. Initial shedding is a common phenomenon during AGA treatment and is highly likely to indicate treatment success. Understanding this information can help alleviate anxiety during the early stages of treatment.

The following article explains the reasons why people consider stopping AGA treatment when they don’t see results.

The Mechanism Behind Initial Hair Shedding with Minoxidil and Dutasteride

Why does initial hair loss occur? Here’s how it happens.

To alleviate concerns about initial hair loss, we’ll explain in detail the mechanisms of action for minoxidil and dutasteride, the primary medications for androgenetic alopecia (AGA) treatment.

For an overview of the main types of AGA medications, see the article below.

Minoxidil

When the hair cycle normalizes through minoxidil use, the originally thin and short hairs are replaced by newly grown thicker hair. This process is the initial shedding caused by minoxidil, a necessary step for hair weakened by AGA to return to a healthy state.

Minoxidil is a hair growth-promoting ingredient approved in over 90 countries. This ingredient guides hair in the resting phase of the hair cycle into the growth phase and further extends the growth phase, promoting the production of thicker and longer hair.

Which is more likely to cause hair loss: oral medication or topical medication?

Both oral and topical minoxidil medications can cause initial hair shedding. Generally, oral medications, which deliver the active ingredient directly into the body, tend to cause more pronounced initial shedding.

The risks of stopping medication immediately due to initial shedding and how to avoid them are explained in the following article.

Dutasteride (Zagallo)

The use of dutasteride (Zagallo) may cause initial shedding as the hair cycle normalizes and transitions from a previous state of thinning hair to a healthier hair condition.

Dutasteride works by inhibiting the activity of an enzyme called 5α-reductase, thereby reducing hair loss. This ingredient reduces DHT (dihydrotestosterone) production by inhibiting 5α-reductase, thereby normalizing the hair cycle.

Unlike minoxidil, dutasteride’s mechanism does not directly stimulate hair matrix cells. Since initial shedding is more likely to occur when hair matrix cells become active, the possibility of initial shedding occurring during dutasteride treatment is low.

Propecia (Finasteride)

The use of Propecia (finasteride) can regulate the hair growth cycle. During the transition from thinning hair to a healthier state, initial shedding may occur. However, since Propecia does not directly act on hair matrix cells, the likelihood of initial shedding is considered lower compared to minoxidil.

Propecia (Finasteride), like Dutasteride, is an AGA treatment medication that prevents the progression of thinning hair by inhibiting 5α-reductase and suppressing the production of DHT (dihydrotestosterone).

By suppressing DHT production, it corrects disruptions in the hair growth cycle and slows the progression of thinning hair. During this process, existing hair is maintained in a healthy state, making the incidence of initial shedding relatively low.

How long does the Initial hair shedding Phase Last? How much Hair will Fall out?

Initial shedding symptoms vary from person to person, but it is commonly reported to occur most frequently approximately 2 to 8 weeks after starting minoxidil use and to last for about 4 weeks thereafter.

After this period, the hair cycle tends to stabilize, and hair loss due to initial shedding decreases.

To reiterate, initial shedding is not a sign that the AGA treatment medication is not working. Initial shedding is actually a temporary phenomenon occurring during the process of new hair growth. If you stop using the treatment medication due to surprise at initial shedding, hair that was transitioning from the resting phase to the growth phase may revert to a shortened hair cycle, increasing the likelihood of AGA-related hair loss recurring.

The duration of initial shedding also varies by individual, but even for those experiencing it longer, it typically subsides within about 3 months. If initial shedding persists for more than 3 months, it is recommended to consult the physician at your AGA hair specialist clinic.

Is it time for the second hair removal session?

Some individuals experience initial hair shedding caused by minoxidil twice, or occasionally experience it later on. This shedding typically occurs around 6 to 9 months after starting treatment. Hair that had grown back but did not fully mature falls out.

Amount of hair shedding during initial shedding

The amount of hair shed during initial shedding is not particularly large. During initial shedding, it is often fine hair that falls out. Therefore, even if hair loss occurs during initial shedding, it is safe to think of it as “only causing a slight thinning of the hair”.

Normal hair growth cycle

AGA symptoms are closely related to the hair growth cycle. What exactly distinguishes the normal hair growth cycle from the cycle prone to AGA symptoms? The normal hair growth cycle is shown above.

1. Growth phase: The hair bulb is active and hair grows.
2. Catagen phase: Hair bulb begins to shrink
3. Telogen phase: The hair bulb completely degenerates and the hair falls out.
4. Returning to the growth phase: New hair follicles begin activity

In a normal hair growth cycle, the growth phase lasts approximately 2 to 6 years. In AGA, the growth phase ends after several months to about a year, entering the regression phase where the hair bulb begins to shrink.

AGA is a thinning hair condition caused by disruption of the hair growth cycle, and the cause of this disruption is the harmful male hormone “DHT (dihydrotestosterone)”. AGA treatments like Propecia and Dutasteride inhibit the increase of dihydrotestosterone, thereby helping to restore a normal hair growth cycle.

Causes of persistent or recurring initial shedding

Initial hair shedding typically subsides within 1 to 2 months. However, in rare cases, it may persist for over 3 months, or hair loss may recur even after it seemed to have stopped.

Common causes for prolonged or recurring initial shedding include conditions other than AGA, such as alopecia areata, seborrheic alopecia, or thyroid disorders. If you experience unusual initial shedding during AGA treatment, consult your doctor, as another underlying condition may be present.

5 Ways to Deal with Initial Shedding

Initial shedding is a sign of improvement in AGA and evidence that the hair growth cycle is improving. However, many people feel anxious when experiencing initial shedding. Therefore, we will introduce the correct way to handle it when initial shedding occurs.

Reviewing lifestyle habits

A healthy body promotes healthy hair growth. An unbalanced diet, lack of sleep, and accumulated stress can negatively impact new hair growth.

Specifically, be mindful of your intake of vitamins and minerals, and ensure you get 7 to 8 hours of quality sleep.

If you experience initial hair shedding, avoid excessive alcohol consumption. Moderate drinking is acceptable, but heavy drinking promotes DHT production. Additionally, smoking constricts blood vessels and may reduce the effectiveness of AGA treatments by half.

During AGA treatment, limit alcohol and tobacco use.

Use of wigs and hats

During the initial shedding phase, you may consider using a wig or hat to minimize the appearance of thinning hair. AGA treatments like Propecia or Dutasteride typically take at least six months to show improvement in hair thinning. When initial shedding occurs, using a wig or hat is an option worth considering.

Use a mild shampoo

When experiencing initial shedding during AGA treatment, we recommend using a mild shampoo. Shampoos without synthetic surfactants, such as amino acid-based shampoos, are preferable.

Also, after shampooing, be sure to thoroughly dry your scalp to prevent bacteria from multiplying.

Do not use excessive amounts of hair growth products.

When experiencing initial shedding, some people feel anxious and turn to over-the-counter hair growth products. Using such products is not inherently problematic.

However, excessive use of ineffective hair growth products can significantly worsen scalp conditions, so caution is advised.

Scalp massage

The nutrients essential for healthy hair are delivered by the blood. Therefore, promoting blood flow through scalp massage is recommended.

It’s a good idea to make it a habit to gently massage your scalp during relaxing times, such as bath time or before bed.

Conclusion: Initial shedding prepares for New hair growth

If you experience initial shedding while using AGA treatment medication, please remain calm and continue your treatment.

That said, hair loss can still be stressful. If you notice significant shedding of thick hair or prolonged hair loss, feel free to consult your clinic.

Initial shedding is a sign that new hair is beginning to grow. Adopt a regular lifestyle and prepare to welcome healthy hair.